moved that Bill S-201, An Act to prohibit and prevent genetic discrimination, be read the second time and referred to a committee.
Mr. Speaker, it is a great honour to be here today as we consider in the House the first bill that is coming to us from the Senate, and I am proud to be its sponsor.
This legislation was first introduced by Senator James Cowan and has already received unanimous support in the other place. Today I hope to convince members of this chamber to give it the same enthusiastic support in the House and thus change the lives of millions of Canadians.
Genes are the building blocks of our lives. They tell us who we are and where we come from, our inherited strengths, and our susceptibilities. Our genetic makeup is more fundamental than our ethnicity, our gender, our race, or even our sexual orientation. It is the foundation of who we are as human beings.
Since the discovery of the human genome, we know that our genetic codes contain information that can prevent illness, thwart disease, improve or even save lives. The late U.S. senator Ted Kennedy observed the discovery of the human genome would affect the 21st century as profoundly as the splitting of the atom or the invention of the computer in the 20th century.
When Senator Cowan first introduced the bill in 2013, there were only 2,000 genetic tests available. Now today, after three and a half years, there are more than 48,000 genetic tests for diseases like Huntington's disease and early onset Alzheimer's. There are tests for genes associated with ALS, kidney disease, breast and ovarian cancer, and certain forms of colon cancer, and the list is growing at a truly exponential rate.
Canadian scientists last year discovered the gene that was associated with cystic fibrosis. Just this summer researchers have found the gene associated with metastatic, fast-moving prostate cancer, explaining why with some men prostate cancer moves slowly and in others it advances very quickly, perhaps informing treatment or helping people determine their options. This probably explains why my father lived for over 20 years with prostate cancer and yet some of his friends died after only 18 months.
Canadian health care institutions conduct tens of thousands of these tests each year. The information gleaned from them allows Canadian researchers and physicians to diagnose diseases, guide treatment, inform reproductive planning, and warn of adverse drug reactions. They are also used for clinical trials by innovative pharmaceutical and biotech companies to find new treatments for old diseases.
In most cases having a genetic makeup does not mean that a person will automatically or even necessarily develop a disease or condition, only that one might. However, knowledge is power and this opens up the possibility of taking concrete steps to reduce the possibility or the chance that a disease or a condition will develop in the first place.
Perhaps the most famous example of this is actor Angelina Jolie. People will probably know that her mother died of cancer. When she looked at that, she decided to undergo the test and determined that indeed she was a carrier for the BRCA1 gene. Women with this genetic mutation have as high as 87% chance of developing breast cancer and as high as 60% chance of developing ovarian cancer. Ms. Jolie opted to have preventative surgery and reduced her chance of getting breast cancer from 87% down to 5% and reduced her chance of getting ovarian cancer by some 98%. She wrote in The New York Times, “I can tell my children that they don't need to fear they will lose me to breast cancer”.
The benefits of genetic knowledge should be not limited though to celebrities. Every one of us in the House may want to undertake a genetic test at some point. Famous or not, none of us should be denied access to a genetic test and none of us should be afraid of having a genetic test for fear of discrimination.
In the course of working on this legislation with Senator Cowan, I came to know the story of a young man who was only 24 years old who had family members who had tested positive for Huntington's disease. Given that kind of family history, he had to weigh out his options about whether he should actually have the test to see if he carried the same genetic makeup. He took the difficult decision to have that test and he shared that decision with his employer.
On a Friday, he found out he had tested positive and, indeed, had the gene. His employer asked him what the result was, and he was honest and told him. The Monday following, he went to work and was fired. He was a video editor. His employer was afraid, for some reason, for his equipment.
Of course, this young man did not have the disease, does not have the disease, and will likely not develop any symptoms for this disease for maybe as many as 20 years. Huntington's is an area of huge research right now. There are clinical trials going on right now for drugs which would perhaps delay the onset even further. However, he is being discriminated against now for a disease he might never have if medical science works the way it should.
This bill is inspired by the belief that all Canadians should profit from the advances in genetic science. To achieve this goal, the genetic non-discrimination act seeks to ensure that the knowledge that we have through genetic research is protected from potential abuse and that there are as few impediments as possible to getting tested.
In Canada, unlike most western countries, if one has a genetic test, there is no protection from a third party using that information, those test results, perhaps to one's detriment. This is the problem of genetic discrimination and that is what Bill S-201 seeks to address.
Genetic discrimination can take many forms. As in the first story, it can take the form of employment determination, denial of a promotion, denial of child custody, and there are cases of this, an increase in insurance premiums, or even cancellation of an insurance policy. Each one of these is a heartbreaking story.
Dr. Ronald Cohn is a clinical geneticist, now pediatrician-in-chief, at SickKids hospital in Toronto. He testified in the Senate about parents feeling they had to refuse genetic testing, even though it could point to the best way for treatment or care, for fear that their child, who may be sick, could face future discrimination. He spoke of parents who had spent years searching for diagnoses, who broke down in tears as they had to decline genetic testing because of concerns over genetic discrimination.
He described one young patient whose symptoms were consistent with two different diseases, and the only way to promote the diagnosis and get the right treatment was to actually have a genetic test. However, the parents felt unable to consent for fear of discrimination. Dr. Cohn told senators that without the test, he could not properly care for the young girl. Without legislative protection, her parents could not agree to have the test done. This is not a choice or decision a parent should ever have to make.
Canada is one of the few industrialized countries in the world without some sort of legislative protection for its citizens' genetic information. Our laws lag behind Austria, Belgium, Bulgaria, Denmark, Finland, France, Germany, the Netherlands, Norway, Portugal, and Spain. The United States has had this sort of anti-discrimination law in place over 13 years, with the federal genetic information on discrimination act. Twenty-four American states have passed additional legislation limiting the use of genetic information by life, disability, and long-term care insurers.
Renowned award-winning genetic researchers with international experience are expanding their reach of precision, personalized or targeted medicine. The future of medical care is rapidly changing. There has been no significant advancement in anything medical since the discovery of the human genome. Without protection, Canadians will not benefit from these huge advances in medical science. This affects the health of every Canadian that we are here to serve. It affects the future of medical science in our country. Personalized or targeted medicine is the future of medicine and Canadians deserve protection to ensure they get the best care, and that we do not waste health dollars and ensure we have the best public and personal health.
I call Bill S-201 a three-legged stool. Each piece of the legislation is crucial to fighting discrimination. They are, in order of importance: the proposed new genetic non-discrimination act, or what I am now calling the GNA to fight discrimination against RNA or DNA; then the amendments to the Canada Labour Code; and, finally, amendments to the Canadian Human Rights Act. Each part is essential. This bill cannot be arbitrarily disassembled any more that a stool can lose a leg or two and still support us.
Principally, the very first thing is that the bill would create a new genetic non-discrimination act, a GNA, with three new criminal offences. It would prohibit requiring anyone to undergo a genetic test, or to disclose the results of a genetic test, as a condition of providing goods or services. It would also prohibit the collection, use or disclosure of the results of genetic testing without that person's consent. Of course, the bill contains exemptions for healthcare practitioners and for research.
To my mind, this is not controversial. None of these prohibitions are controversial and they are urgently needed. The new genetic non-discrimination act is the single most important part of this bill. The GNA is necessary to fight DNA or RNA discrimination.
It states clearly and unequivocally that society condemns genetic discrimination. It is unacceptable behaviour, and it will not be tolerated. The criminal sanctions are set high to serve as an effective deterrent. The bill does not target sectors or industry; it targets bad behaviour. It names the bad behaviour and ensures that there are laws to protect people against those behaviours.
Our job as federal legislators is to put into place laws that will protect Canadians. We have the criminal law power to do that work. That criminal law will state what is unacceptable conduct, and then prohibit that conduct. That is what Canadians expect us to do on their behalf.
Second, Bill S-201 would amend the Canada Labour Code with a set of amendments, providing a complaint procedure for employees in federally regulated workplaces who encounter genetic discrimination. I know this number is not large, but nonetheless they are important and this could serve as a model for other jurisdictions.
Last, there is a set of amendments that adds “genetic characteristics” as a prohibited ground of discrimination under the Canadian Human Rights Act.
This is a three-legged stool with an act, with criminal penalties, changes to the Labour Code, and changes to the Human Rights Act, holding us up as a robust piece of legislation that will protect our rights as Canadians and ensure the best health of Canadians.
It is interesting. I have heard that there is some sense that we should not have a stand-alone act, but it is fine to simply put this into the Canadian Human Rights Act.
Peter Engelmann, a labour lawyer and human rights advocate, former counsel to the Canadian Human Rights Commission, told senators why, in his opinion, the specific protections as were proposed in the genetic non-discrimination act were critical, and why just amending the Human Rights Act alone was not sufficient.
The reality is the way human rights legislation works is it is reactive instead of proactive. It puts the burden or the onus on complainants. They bear the costs. They bear the burden and the stress of taking a complaint forward, which is after the fact not before the fact. There are not significant deterrents in it. Sometimes people are very vulnerable in difficult positions in which they should not have to be.
The act would ensure we have, together, one act that would make it a crime against Her Majesty, against the state, and thus would ensure that we would have adequate protections to do that.
Senator Cowan presented an earlier incarnation of this bill and tested its constitutionality. The Senate has deemed, indeed, that we do have the federal power to enact this sort of legislation to ensure that Canadians are protected.
Law professors, experts, will disagree. Essentially, I hope the Standing Committee on Justice and Human Rights will examine that thoroughly. I am convinced it will find that we do have the federal authority, the federal power, as we do in other areas of legislation, to enact this sort of bill.
The federal government has that power in securities, in tobacco marketing and other things under so-called provincial jurisdiction, however, we believe this is the right thing for the federal government to do.
Canada is behind. Canada needs to step up to the plate. Canada needs to do this now. We are behind and we need to act. This is our chance, as legislators, to bring better health to Canadians and ensure that Canadians have access to genetic tests. We, this day, will be able to save lives.